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The Forest As we drove farther into the outskirts of Augsburg, looking out placidly across the top of cars, houses, and at the dogs running about, I got thinking, thinking how I felt being with Chris, about Chris. It was like I was cast into a spell, an enchantment, or perhaps a curse; very seldom did I ever feel like this. Normally I would feel like this only if I was in the presence of a great person, like my karate instructor in San Francisco, Gosei Yamauchi, or his father ‘The Cat’ Gogan, who was one of the few 10th degree black belts in the world. Normally I’d be high the whole next day. With Chris I felt the same way I knew tomorrow I’d be high all day, it was a natural high. Once—I can’t remember when—I had read something about the poet Emily Dickinson, she was something like a recluse, but she made a poem indicating nature was her high, and I always remember that. How true this can be, grabbing the moment and cherishing it, absorbing it as if there was no tomorrow, and at the same time absorbing nature: the sounds and the heart beat mother earth, and sky; others humans, and the dogs and birds, all such things that at that moment surround you; they are all somewhat magical. I was learning, how to be a listener if anything and it entailed all things within your presence. Chris was fully alive now, as I turned my head towards her delectation her steering wheel facing me, at which made the moment a little more interesting, as she felt good about me checking her out; a weary kind of sense, not defeat, just a good profile look; I thought dimly in my mind as she drove mile after mile: how could she afford to look so prim and proper all the time. Do her hair in a unique style, not a hair out of place, so it seemed. I guess in our own way we are all unique, I heard that someone say that someplace, not sure where. An hour and a half had passed on by and she was still driving, and it was getting dark. She pulled into a wooded area; she said it was the outer rim of the Black Forest (otherwise known as the Eyebrow of the Woods), I think I heard of that forest in a fairytale book or at least that is where my mind said I got it from. An enchanting name, I must had said it my second self, that little person inside of all of us that we talk to: Black Forest, Black Forest…! “So you see,” said Chris “…here we are!” She added her conclusive little smile to her face as she said that; as we entered the dark huge green forest, parking the car a little off to the side of a dirt road that lead into the deeper and more distant part of the forest, partly covered by trees and bushes now. There was a chill in the air so I rolled up the window, as she turned on the radio for some music. Very quickly and carefully she moved her thin reserved neck and shoulders into my area, she just starred at me, as if she was going to eat me up; as her left arm was lowered, it pulled out a bottle of Mosel-Saar-Ruwer wine, 1965 wine, -- I looked the bottle over 9.5% volume; I knew they had been making wine around this intriguing river and hilly area for close to 1700-years. It was good wine I had tasted it before, not sweat or dry, flowerily white wine to be exact. “Now,” said Chris indignantly, but with the air of a certain point, “…let’s see what we can do with this battle. We started to drink and laugh. “Ah, yes,” I said to her, “you have a lovely profile.” She smiled and threw her head back. “Well,” I thought out loud “… this is a good way to pass the night away, and begin romantic indecencies”-- she leaned over the center-divider of the bucket seats to kiss me. She opened her mouth, sunk her lips on mine, as she pulled her long legs to the under-part of the dash, she then started to unzip her zipper to her boots. “This,” commented Chris “passes everything…I never did it in a car before.” She had drunk down 1/5 of the wine like a person drinking water. “Chick,” said Chris, ”…come over here.” I moved my body closer to hers. Everything seemed to be in the way. I could not back out of whatever was going to happen; and I knew what was in the makings. She was starting to stretch her hands out: --her blouse went over her head, I just kept looking as she started to strip, I was growing, getting as hard as a pencil. “Oh, damn Chick,” said Chris heartily as she touched my item. Just her saying that aroused me; then pulling off her bra, and her skirt up I seemed to become tranquilized somehow, my mind slipped to King Solomon, of all things, as he once defined the beauty of a woman’s body and how it was to measured for one’s pleasure by enjoying it fully, and this was all I wanted to do now—enjoy it, and I think Chris was feeling the same way for even though we were both a bit on the tipsy side we were fully aware of our responses, I had lost complete focus of the uncomfortable situation, as she did… ◊…now that she was almost completely stripped only her panties on, she curled up in a fetus position holding her legs and leaning back, then opened up her legs slowly… I thought what every on earth possessed her, yet who can predict women I told myself, and started to take off my cloths, quickly…getting out of this spill of sorts. I guess it is true, men like to observe, and women like to touch. I liked both. This was not dirty sex, this was pure sex, at its height, one might even say, it was like a painting; she painted the picture, she taught me how to enjoy what she had to offer. “I’m going to get it all off in a minute,” I said, it was difficult working in this cramped space… she chuckled, “Slowly please, I can wait…”she softly said as she rested her head back and I caught my breath, that is what she wanted, that is, for me to calm down, yet remain hard and possessed with her offering: I think we both had multiorgasms “I feel fine now –“ I said, adding, “cramped but fine…☺” Chris opened up her arms I couldn’t back away after that, could I? I told myself: I have a private room at the barracks…. Then said it out loud to her: “Of course, -- next time…” said she, and we continued to make love for the third orgasm for me, for her, perhaps five or six. We seemed to flop around the front seat finding the right position…’she‘s looking at me eeeeeeeee’, I told myself, I’m cramped, nothing to grab a hold of, her head leaning against the glass of the window. Without a word we continued: --my body heavy onto hers, my heart beating two-hundred ticks a minute, we both were hot, enmeshed in the moment, a lustful, and burning moment; I wanted to open the door, but feared the light going on and someone would see us, plus the air was cool, too cool. I had no escape we met each other’s eyes as I penetrated her. She looked again deep into my eyes as she tried to catch her breath, to make sure I was still alive I think. It was seemingly unfair for me to put her through this I thought, but the thought only lasted a half second, I found myself exploding … as my heart dropped to my feet, and again, and again, I exploded and burned as if I had opened myself up to a volcano; I had learned at that moment, the difference between happiness and pressure: happiness was listening to her talk before, and then came her smile, now the pleasure, sex; I hurt, this had never happened before. “Nice evening, isn’t it?” I said as I started pulling her body closer to me. “I hope you are not offended I am taking the lead?” said Chris. “Not at all,” I said, adding, “I’ll catch up.” “There are times,” said Chris, “when rules are made to be broken like now, them...mmm damn silly rules…” she pulled herself up a bit, “I stopped believing in those rules… this is one of those moments I want to remember…remember for a long time, even after I am dead.” As we tried to untwist our bodies, we caught ourselves laughing at our odd situation. We had made love, and became a little more sensitive with each other…a little more possessive of each other, I guess that is the nature of things in a relationship, they are made to progress, or stop, one or the other, and it was never to take place again in the front seat of a Mustang I knew…. She laid her cheek against my hand. “Chick.” “Yes?” “You realize don’t you, this can’t end here?” “There’s no reason for it to end, is there?” “No.” She spoke some German words I didn’t understand, German mingled with English I should say: then somehow, she went silent…maybe she was taking time to remember the moment, digesting it; I didn’t know, nor did I want to try to guess, I just looked at her, her smile it seemed to promise something, grace; instinct was in it also, around her small enclosed eyes, as they opened and shut slowly they were weaving a web I do believe, “It won’t end here, I promise.” Pleasant and agreeable-like a well-cultured woman she was, maybe too much for me, she opened the door, and dressed quickly, then got back in. “Want a cigarette?” I asked, sitting up straight. “No and neither do you. We are both restless it seems. Come over to me,” she started kissing me. As she released her lips from mine, she sat upright now, pulled out a cigarette, lit it and started blowing smoke rings into the air. “You know perfectly well, I’m very much attracted to you…yoouuuu… right?” “I hope so, I feel the some way.” “Luckily the wine deadens the bruises (discoloration).” I commented, she laughed and kind of stretched her back to put it back in place…”Me to,” she replied. “I wish all relationships could start like ours, it is like saying let’s drop all the game playing and pretend we are on the fifth date, and cut the crap; I like you Chick, I like you very much…” “The bruises will show up tomorrow,” I told Chris. Kind of saying maybe we should go, but neither one of us seemed to be all that bothered with that so we simply started kissing again after her cigarette brake…it was a long and needed pause for me, for a second breathe, a refractory period I needed [from uninterrupted sex]; that is, having multiple orgasms drains a man. I’ve learned also, women don’t need this rest period; so in time I’d learn how to last longer, and perhaps stretch the orgasms thinner but again, longer (three hours at the most; and I did). I thought in my head, she was having sex with me, and then that rich boyfriend she had; she was getting her multiorgasmic pleasures indeed, perhaps a secret to some women, for once they discover this, it is hard for any man to keep up with them, lest he be a superman of sorts. I did not even at that young age have the capacity to pass six organisms; five was my limit I learned. I was limp now; my penis had been as pointed as a scorpions tail a while ago. As scary as it started out for me I thought my reactions afterwards was cool, I seemed to be letting things take their natural course. It was a dark and colorless evening. Grossly romanticized in such an unimpressive way (so I thought in the back of my mind), yet Miss Chris was perfect. I thought to myself: maybe she might be annoyed with my lovemaking… I guess every man wants to please the woman, wife, girlfriend, the one he is making love to, or should want to please her, but most don’t; how can they, they pop too quickly. This is a fact, I’ve talked to men, and when they say they go so quick, no woman could get it on in that time period. A woman taught me how to hold myself from climaxing too early, thus allowing the woman to catch up—and therefore, allowing my female mate to get it on and enjoy. I know this evening went a little fast, but Chris was modest about it, like that other woman who had taught me, helped me, to help her, so we both could enjoy each other more; as my slowing down kept my penis hard longer, allowing her pleasure zone to become wider. This was something of the case in hand, but not completely. Most men think they make love better drinking, but it’s far from the truth. Most men do not know how to make love, no one taught them, so all they do is f*ck, and that is not love, that is, if anything, a quick climax, like eating a big fat burger, and wiping your mouth in its enjoyment and then leaving the café only to find out: you got indigestion, and had you went to a nicer restaurant, ate slower, you’d never forget the meal. I have experimented with that theory, and it is nine-minutes verse four-hours, I say four hours, but I knew in my head it was only one time I lasted four hours, two and a half was the norm. I was thinking now—as Chris kissed me—how I owe some women a bit of gratitude for allowing me to have my pleasure and not returning it to them; that’s the caretaker in a woman I think. But women just don’t know men can learn. And men are too bull-headed to let women teach them what pleases them. I had learned a good lover was worth his weight in gold and even maybe a little more: sometimes they can be irresistible. One could hardly tell her it wasn’t hastily done, our sex (to me it was) for it was, but she seemed to understand the circumstances, and we need not prove anything today, only allow our bodies to be sanctioned to the other. So I think we both felt. Lovemaking would improve as time went on. “I’m afraid my lover, we will have to find better accommodations next time,” Chris said, smiling at me. “Yes,” I hesitated, “absently,” I hesitated-- “I feel the same way.” “It’s a little hard in such a cramped car luckily we are both a little tipsy….” “I’m afraid I’m not, somehow I sobered up when you took your blouse off.” She smiled, with a grin. “Yes. I sense you have, do you really like me Chick?” “You are growing on me. And what is there not to like?” She was like a schoolgirl at times, needing to be encouraged, to grow up, and needed to be admired. But she didn’t need permission to live, she was taking that—but I’m learning to appreciate women more, I told myself, and it seems the more I show appreciation, the more they respect me, and to be quite frank with myself, I need respect. And why not … the world will give it, if you demand it, and if not, let that part of the world go; so my second self, my mind’s eye, told me. But then as I looked at her, if she really felt she was on death row, with cancer, maybe I was just a remedy for a while, and if so, so what, maybe I needed a remedy to make it through my time here in Germany; so seemed just to me. 8 The Spider and The Web A warm-wind had picked up it seemed, and April and May in Germany was a paradise of light-cool sunrays, it was a spring never to forget, Chris and I were growing on one another, like white on rice. More community drinking fairs were picking up and Chris and I tried to make a few, drink it up and eat and just go with the flow; it was a good time for living. Chris and I were known throughout the guardhouse-barracks as lovers and a heat wave at that. She seemed to have a charm with my soldier friends, and often drove her German boyfriend’s Mercedes car to the gate, and about, showing off kind of, not only to me, but it seemed at times going out of her way to show it to the other guards. Most of my friends thought she had two cars, I simply did not up date them, if they were not in my way of thinking or inner circle—why squander my time; and in most cases they didn’t have a need to know; but Ski and a few other of my friends knew the truth. I felt: plus, I felt: why not let Chris make an impression at the guard shacks, if it helps her ego so be it. I do not think I was envious, rather amused. I’m sure somewhere along the line I’d have to deal with envy, but who at my age is envious, for what, I have a lifetime to catch up. She flirted with the guards, and they all thought it cool. At night, if I had to work, she would bring me by a sandwich while on duty; in one way she got the guys a little jealous, or in lack of a better word, annoyed. And sometimes she would simply walk into barracks, which had about fifteen-guards some running around half naked from the shower room to their room, while others went visiting. She’d come knocking on my door. She’d spend the night with me, it was an improvement from the car, and for some reason we only went over to her house once in the following two months. I knew we were not fooling anyone at the guard-barracks, but we pretended to be secret about it anyway. penis elargement traction device free penile enlargment technique free exercise tip for penis enhancement penis enargement pump penis elargement operation manual pennis enlargement penis enhancement procedure penis enlargement pills product

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The prostate gland forms part of the male reproductive system and is responsible for the production of a clear liquid which makes up about thirty percent of the seminal fluid used to carry and protect the male sperm during intercourse. The prostate gland sits just below the bladder and in front of the rectum, partially surrounding the urethra which carries urine from the bladder out of the body. During childhood the prostate gland is very small (about the size of a pea) but will grow rapidly during puberty in response to the production of the male hormone testosterone. In a mature male the prostate is typically the size of a walnut and weighs about one ounce. The prostate gland is divided into the three sections – peripheral, central and transition. The peripheral section is located at the rear of the prostate gland and is the section of the prostate in which prostatitis and prostate cancer are most likely to develop. The transition section, which lies in the middle of the prostate gland and surrounds the urethra, is the area in which benign prostatic hyperplasia (BPH) is seen. There are a variety of problems associated with the prostate gland, the most common of which is BPH. This condition, which is a growth of non-cancerous cells within the transition section of the prostate gland causes an enlargement of the gland and exerts pressure on the urethra which, in turn, leads to difficulties in urinating. Other common problems include prostatitis, which is an inflammation or infection of the prostate gland, and prostate cancer. Enlargement of the prostate gland will affect about half of all men by the time they reach the age of 60 and increases with age to affect some ninety percent of the male population by the age of 80. Prostate cancer will affect approximately seventeen percent of the male population and results in the deaths of over 30,000 men each year in the United States alone. com enlargment penile penile pump best penile enlargment surgery vimax pillss inch medical penis enlarement free penis enlargment exercise penile enlargment without pills enhancement manhattan penis surgeon pnis enlargement tip free exercise tip for pnis enlargement

Penile Implants These are the most irreversible and drastic ways of achieving artificial erection. Only when all other measures have been exhausted with no longer-lasting effects are achieved is that penile implants are warranted. These are prosthetic devices made of inert silicone, which are surgically inserted into the penis. Normal erection cannot be achieved after that. There are two kinds of penile implants: Passive Implants: Two rods of silicone are inserted into the penis, which remains erect all the time. The silicone rods can be put in different angles, but this may be an embarrassment in public occasions such as swimming. Orgasm may be achieved unless there are hormonal or neural factors which impede it. Active Implants: These are inflatable silicone pouches which are also implanted into the penis. The penis remains in flaccid state until a proper manipulation of the prosthesis causes its inflation and consequent erection. One type of implant is activated by pressing the glans (the head of the penis) with one hand. Liquid is transferred from a reservoir to the main inflatable pouches. In another type, the liquid reservoir is implanted into the scrotal sac, and can be pumped by hand. Other Treatments Other surgical and non-surgical treatments for impotence are being tried in an experimental basis, and there may be a promising future for some of them. For instance, groups of physicians in Russia and Germany have been experimenting with electrical stimulation of the pelvic area using an external pad applied to the abdomen and back. There are already commercial devices using this principle, which seems to increase the blood flow in the genital area. Direct stimulation of pelvic nerves (leading to a nerve-induced erection) by using implanted electrodes and an electrical pacemaker-like device are also being considered. "Natural" or alternative methods do abound. They range from "natural" foods which have high testosterone or DHEA levels, such as green oats (marketed under the brand name of SEXATIVA) or saw palmetto; to yoga exercises to increase muscle tone and blood flow in the genital area. It is hard to say whether there are real effects or they are just the effect of suggestion or placebo phenomena. One thing has been scientifically determined, however. The blood levels of testosterone increase just after exercise, or by loosing excessive weight. Thus, a natural way of combating mild hypogonadism might be frequent exercising and keeping a normal weight. Controversial and unapproved treatments Controversial and unapproved treatments Bremelanotide The experimental drug Bremelanotide (formerly PT-141) does not act on the vascular system like the former compounds but increases sexual desire and drive in male as well as female. It is applied as a nasal spray. Bremelanotide works by activating melanocortin receptors in the brain. It is currently in Phase IIb trials. Ginseng A double-blind study appears to show evidence that ginseng is better than placebo: see the ginseng article for links and more details. Enzyte Enzyte is a product that has been advertised by saturation coverage on television channels such as Court-TV. However, the Center for Science in the Public Interest (CSPI) has filed a complaint with the Federal Trade Commission (FTC) about Enzyte for deceptive advertising. It is manufactured by Berkeley Nutritionals, which is alleged to be the subject of an investigation by the Attorney General of Ohio and the defendant in class-action lawsuits. Enzyte is a supplement that claims to increase the male libido or frequency of erections of the penis. Commercials for Enzyte are shown regularly on television. These commercials feature a man named Bob who never stops smiling, apparently because he had taken Enzyte and improved the size of his sex organs. The commercials are riddled with symbolic phallic imagery, e.g. golf clubs, remarkably tall glasses of iced tea, and a hose spraying barely a trickle of water (carried by someone who doesn't use Enzyte). The effectiveness of Enzyte is in dispute. Some medical professionals in fact advise against taking Enzyte, saying that it can lead to damage. The Center for Science in the Public Interest have urged the Federal Trade Commission to disallow further television advertising for Enzyte due to a lack of proper studies supporting claims. Enzyte maker Berkeley Premium Nutraceuticals, Inc., is currently under a class action lawsuit for false advertising. Enzyte is said to contain: Tribulus terrestris; Yohimbe Extract; Niacin; Epimedium; Avena sativa; Zinc Oxide; Maca; Muira Pauma; Ginkgo biloba; L-Arginine; Saw Palmetto. Other ingredients: gelatin, rice bran, oat fiber, magnesium stearate, silicon dioxide. Herbal and other alternative treatments These are generally ineffective when tested blind, but may be useful for their psychological (placebo) effect: if a good result is expected, any highly-praised, and often expensive, treatment can be effective. Reputable drugs can also benefit from the same effect. Uncontroversial treatments for erectile dysfunction PDE5 Inhibitors The prescription PDE5 inhibitors sildenafil (Viagra®), vardenafil (Levitra®) and tadalafil (Cialis®) are prescription drugs which are taken orally. They work by blocking the action of PDE5, which causes cGMP to degrade. cGMP causes the smooth muscle of the arteries in the penis to relax, allowing the corpus cavernosum to fill with blood. Vacuum pump An external vacuum pump will produce an engorged penis with success approaching 90%; a penis ring will maintain this state, although it should be removed after not more than 30 minutes. The erection is not as rigid or hard as a natural erection; drugs or injections, when they work, may be preferable. Various studies show the degree of satisfaction of users and their partners to be vary variable, even when drugs and injections do not work; in one study, about 20% of men who tried a (high-priced) pump decided to proceed to purchase one. Other studies show higher percentages of satisfied users. In some cases frequent use of a vacuum pump can eventually improve the degree of erection attainable without use of the pump. Claims of cheap "penis pumps" to permanently increase maximum penis size should be viewed with caution, however. Some vacuum pumps are sold at a higher price with 100% refund within 90 days to dissatisfied users, with a somewhat lower price with 50% refund guarantee (Osbon Erecaid, [7]). This pump is supported by medical insurance schemes, including the UK's NHS and US Medicare and private insurers. The better-known pumps sell for prices of around 200 GBP/400 USD (2006). There is at least one vacuum pump with rings which sells for around one-fifth of this price (Noogleberry, [8]). Specific devices are mentioned for information only; mention should not be taken as endorsement. pnis enlargement information penis enargement pills vimax penis enlargement before and after picture vimax best penis enlargement pro solution wealth pennis enlargement pump penile enlargement surgery cost penis enlargement procedure free exercise tip for pnis enlargement

The new gimmick of the town, GOJI, people are going gaga about this Berry. The new libido enhancer berry can ‘make Viagra run for its money’! Pfizer may laugh at this statement! Yet another misunderstanding of total Viagra mechanism! The hot favorite ED medicine of the nation is still being misinterpreted even after eight years of its regime. The Goji berry has been given a pet name “Natural Viagra” by those Goji sellers who want us to buy them. Before you get convinced about the ‘Natural’ Viagra, let me again explain what is Viagra and what exactly Goji berry does to you. Goji is a Himalayan berry found and grown in Tibetan and inner Mongolian area. There is another wrong notion running on the minds of the people that Goji berry means Wolfberry which is found in China. The fact is that they are different types of berries, Goji berry is much sweeter, better in taste and contains extremely high level of antioxidants, vitamins, calcium and minerals. The scientific name for Goji is Lycium barbarum and for Wolfberry it is Lycium Chinese. In many articles across the internet we find the Goji sellers are stating that Viagra, the artificial libido enhancer is now being replaced by Goji, the natural remedy to boost your sexual drive. Celebrities like Madonna and Kate Moss are said to eat Goji for its benefits. True that Goji has 500 times more Vitamins compared to oranges and can slow ageing process, improve skin and protect from any type of cancer. May be it can enhance your libido…that will be an added advantage of buying this costly fruit. Is it not obvious that with a fit body, you are more likely to enjoy sex and feel like involving into sex? So, naturally Goji can be a good libido enhancer…but hey! Please stop saying that Viagra is going to get a run for its money! VIAGRA IS NOT A LIBIDO ENHANCER; IT IS NOT A LIFESTYLE MEDICINE WHICH INCREASES YOUR SEXUAL DRIVE. IT IS A TREATMENT FOR ERECTILE DYSFUNCTION AND IT REQUIRES SEXUAL STIMULATION TO GIVE YOU AN ERECTION. VIAGRA RELAXES THE MUSCLES IN THE PENIS AND INCREASES THE BLOOD FLOW TO GIVE A STRONG ERECTION SO THAT IT MAY RESULT IN SUCCESSFUL VAGINAL PENETRATION AND INTERCOURSE. The above information is already known to you, but I am trying to remind you so that you keep it in mind, what Viagra actually does to you in case of erectile dysfunction. It was for those who get swept by the sales talks and forget the repeatedly told facts …just like we forget real meaning of the statutory warning written on the pack of a cigarette “Cigarette smoking is injurious to health”…remember! You have a problem with your penis erection, but not with your sexual drive, or libido. Because you can get sexually excited but cannot get a firm erection or sustain your erection for vaginal penetration. Libido and impotence are total different aspects of your sexual life. You have to understand this. If you are person with erectile dysfunction and have started eating the Goji berry in anticipation of a great sexual experience …give it a second thought, you are going to waste your money? In such a case, the Goji berries cannot help you. The only way remains the PDE5 inhibitors by which you can get an erection for your penis. Of course Goji berry may replace your artificial means of vitamins and minerals! But if you are one of those who wish to enhance your sexual drive, remember that if you are suffering from weakness due to lack of vitamins and malnutrition, you will naturally be lacking sexual drive and suffering from low libido. Once you overcome these weaknesses and have a healthy body, your sexual drive will automatically go up! This is what Goji berry can do to you…and this is no miracle, just science! penis enlagement fact vimax results medical penis enlargement free exercise tip for pnis enlargement vimax penis enlargement program free penis enlargement exercise penile enlargment pump penis enlagement program free exercise tip for pnis enlargement

Heel pain, also referred to as plantar fasciitis or heel spurs, is one of the most common foot conditions treated in a podiatrists office. In our fast paced lives, heel pain has become an epidemic. This is due to the combination of long work days and lack of exercise. People are also gaining weight and losing their muscle strength and flexibility. These are all contributing factors to heel pain. Typical symptoms consist of pain when getting out of bed in the morning and after sitting. Many people also experience discomfort at the end of the day or the day after exercise/strenuous activity. Others describe their pain as radiating or sharp shooting pain which likely involves a nerve in the heel area. A major support structure known as the plantar fascia is partially responsible for supporting the foot arch and for absorbing shock while walking. The fascia extends from the heel to the ball of the foot. The fascia is a flat band similar in makeup to a ligament. For various reasons, the fascia weakens and causes the arch to fall, thus developing a lower arch or “flat foot”. As a result, there is excessive stretch or tension on the fascial band which causes inflammation or swelling and often small tears of this band. With repeated stress of the fascia on the heel bone or calcaneus, a spur or bone enlargement develops. This is the body’s way of responding to stress. When a tissue is stressed, the body forms more of that tissue, in this case bone. In addition to the swelling of the fascia, there is often a related irritation, entrapment or enlargement of various nerves around the heel. It has been shown that these nerves are a major source of the pain experienced with plantar fasciitis. So what exactly causes the pain in the heel? It is a combination of swelling of the fascia and the irritated nerves of the heel. The heel spur itself causes no pain even though on x-ray it looks pointed and appears as piercing object. As a matter of fact, many people have fasciitis without the spur. Dr. Marc Katz, a Tampa Podiatrist, notes that in his 17 years of practice he has rarely removed the actual bone spur. He also stated that over the past 10 years he has used advanced treatments to heal the pain and more recently has used a cutting edge technology known as Cryosurgery with a high success rate. Dr. Katz is the first Cryostar certified Cryosurgeon in the Tampa area for foot problems. How do we treat Heel Pain? Treatment of heel pain can be frustrating for the patient and physician. Healing can take months and sometimes as long as a year. This does not mean that there will be constant pain for that period of time, however, expectations need to realistic. It is important to seek early treatment. There are many treatments for heel pain. Your doctor should customize a treatment plan depending on individual factors including lifestyle, foot types and any other associated illnesses. Treatment should not only concentrate on the heel but also on the person as a whole. Many factors both physical and psychological may be important to consider. In addition, weight control, systemic medical conditions and injuries should be evaluated. Evaluations consist of a thorough history and physical, x-rays, diagnostic ultrasound and MRI if necessary. Referrals to other specialists may be needed if there are associated medical conditions. Treatment may include anti-inflammatory pills, ice, cortisone injections, custom orthotic arch supports, padding, strapping, night splints, removable casts, stretching, physical therapy, shockwave, homeopathic and natural medicine, change in activities, weight-loss programs, wearing different shoes, change in activities and change in life style. Dr. Katz stated that Cryosurgery is showing some excellent long-term results! This newer treatment is recommended after trying other treatments. However, at times it may serve as a first line treatment for certain patients. This procedure is done in the office and is minimally invasive and allows the patient to quickly return to normal activities. The patient is always advised that to help prevent recurrence of the condition, custom orthotic devices, continued stretching and body weight control are necessary. Treatment of heel pain can be a challenge. Find a Podiatrist that is compassionate and willing to spend the necessary time and try different treatment options.